'As a student nurse would you feel comfortable raising concerns?'

It has been a difficult week for nursing, what with the publication of the Francis inquiry in to the failings of the Mid Staffordshire NHS trust and highlighting of concerns within the NHS in general.

This is nothing new – just look at Winterbourne and Margaret Haywood’s filming of the Royal Sussex Hospital.

Our tutor pointed out that at Mid Staffordshire there were no records of student nurses raising any concerns about the practice going on there

Before the publication of the enquiry our cohort had a session on ethics in mental health nursing. The conversation very quickly turned to “whistleblowing” and experiences of bad practice. Our tutor pointed out that at Mid Staffordshire there were no records of student nurses raising any concerns about the practice going on there.

A fair amount of the class admitted that as students they wouldn’t feel comfortable raising concerns either, the main worry being that they would fail their placement if they did so.

I haven’t had to report any concerns during my placements but I have had to when working as a support worker. There were ongoing issues surrounding medication and I felt as if my worries about it were taking over my entire life. I’m not exaggerating when I say that I spent every waking moment wondering what was happening at work and I was struggling to sleep as a result.

I can honestly say that even as a student nurse, I would raise any concerns that I had

I raised my concerns several times but as I worked as part of a small team where there were only two members of staff on duty on a shift it meant that when I raised a concern, it was obvious it was me who did it. In addition I was not supported at all by my manager, meaning I had to take my concerns higher. It made my working life extremely difficult but I wouldn’t have been able to forgive myself if something terrible happened as a result and I hadn’t reported it.

That’s why I can honestly say that even as a student nurse, I would raise any concerns that I had. As mental health nurses we care for some very vulnerable person and raising concerns about bad practice that could endanger them is part of our duty of care.

Whistleblowing takes a lot of courage and confidence, it is by no means easy. I hope that one of the implications of the Francis enquiry is that we are more supported in raising our concerns and that they will be taken seriously. After my experience of it I learnt to keep notes, dates and times of things to back myself up. As students, remember you can report your concerns to your tutor and university as well.

Has anyone had experiences of whistleblowing during their placements? How were you able to deal with it?

Readers' comments
(9)

Anonymous | 12-Feb-2013 3:00 pm

In year 2 , I whistle blew on an Elderly Care Ward, the care of which made my heart sink. I could not believe that the patients were treated in such an undignified manner in a University Hospital. I shall not relate the details but I must say that I was experiencing anxiety and stress during the actual time of blowing the whistle. I heard of so many scapegoating stories and had been worried that I may be targeted in the future. However,I was fully supported by the chief nurse from the Trust itself and this has reaffirmed my faith in nursing. If I witness bad nursing practice again, I would confront it as I would never wish to see any relative 0f mine to experience poor care and degradation.

I must add that there were five other students on the same ward at the same time as me. No one else spoke up about the poor practice and this made me question myself evern more. Whistleblowing isnt easy. It made me think that I was unreasonable but I knew that my conscience would not rest if I kept my head down and said nothing.

I don't know if this is a consolation or not?I started nursing as a student in 1972, at an old style "Asylum" Hospital.I started after an enquiry provoked by Student Nurses.http://www.whittinghamhospital.co.uk/The_Inquiry.htmlIt did improve standards of care.Not for the whole care system, and not for long enough, but things did improve.

It can be a scary decision to whistleblow, but I have and will do it again if I see patients at risk. As a student I have been supported with my decision, but if I had not I may have reconsidered my career choice. I could not possibly stand by and watch patients at risk and not speak out about it.

A fair amount of the class admitted that as students they wouldn’t feel comfortable raising concerns either, the main worry being that they would fail their placement if they did so.

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Well, this is why concerns need to be raised via some sort of intermediary, and preferably after a peer-group discussion to consider whether the concern has got much support from 'fellow workers' - everyone has got this 'If I speak up, I might be victimised' worry, all of the way up to Chief Executives of trusts and even higher.

But people need to discuss concerns - sometimes you would learn why 'we know this isn't perfect, but it is the best we can either think of or actually do at present', and at other times more minds might lead to a solution, or else highlight a problem that had not been spotted.

It is indeed a 'culture' thing - saying 'this seems to be 'wrong/inadequate/dangerous' has to be seen as positive, not negative !

It isn’t student nurses, or nurses, or doctors or managers who are inhibited from raising concerns – it is ALL NHS staff. There is piece in The Times today (page 8) in which some senior doctors are commenting about NHS staff who speak up about concerns, and I reproduce some extracts below – this is a general attitudinal problem in parts of the NHS, with people who raise concerns being harassed rather than being treated as ‘critical friends’ (the crucial bit, in my opinion, is “Professor Williams said that staff were being victimised despite decades of promises from NHS leaders that those who raised concerns should be supported.”):

Two of the country's leading medical Royal Colleges spoke out on the furore over the silencing of NHS whistleblowers which has broken out in response to the Mid Staffordshire scandal.Norman Williams, president of the Royal College of Surgeons, said that pressure to ignore problems was widespread, while Sir Richard Thompson, president of the Royal College of Physicians, said that hostility toward those who spoke up was hampering efforts to investigate poor care. … Professor Williams said that staff were being victimised despite decades of promises from NHS leaders that those who raised concerns should be supported. The college issues guidance to surgeons today on how to resist pressure. "There is no question from speaking to different fellows and members around the country that this is still going on," he said. "Coercive practices" were "relatively widespread" and were harming patients, he warned."If you're getting pressure on you to do something that you feel uncomfortable with because it might affect patient care, and you succumb to it, then patients are going to suffer," he said."It's not just clinicians that are getting pressure. Our information is that managers are also getting quite significant pressure ... We certainly have had instances where managers have complained to us about the inordinate pressure they are getting."

This is the number one problem I have come across personally at university and on placement, the confidence to "whistleblow", raise concerns or whichever term you may choose to use, is simply not as high among student nurses as it should be. Perhaps the constant barrage from the media and press has not helped over time. Whatever the answer, student nurses really should be listened to, because nothing can change in the NHS without them. NOTHING!

Well done for having the courage and convictions to whistleblow to prevent further poor care to patients.

There's too many people just moaning about poor conditions, but not quite having the courage to take it further, possibly worried about their own position or that they also feel responsible. Very difficult to stick your head about the parapet.It's very sad when there's the feeling of victimisation and severe lack of support from others, possibly as a result of poor care and treatment of the staff by an organisation. It's very easy for policy-makers to say we should do it, but then not to provide full protection and support to those that do does not help anyone.